Budget Impact Analysis of Venetoclax Combination Therapies for the Treatment of Newly Diagnosed Acute Myeloid Leukemia Patients Who Are Aged 75 Years or Older, or Who Have Comorbidities That Preclude Use of Intensive Induction Chemotherapy
Author(s)
Yanqing Xu, MD1, Janet Nguyen, PharmD, BCPS1, Kaylee Miu, PharmD1, Chia-Wei Lin, PhD2, Melissa Montez, PharmD2, Xinglei Chai, PhD3, Xin Chen, PhD3, Thomas Leblanc, MD, MA4;
1AbbVie Inc, North Chicago, IL, USA, 2Genentech, Inc, South San Francisco, CA, USA, 3Analysis Group, Boston, MA, USA, 4Duke Cancer Institute, Durham, NC, USA
1AbbVie Inc, North Chicago, IL, USA, 2Genentech, Inc, South San Francisco, CA, USA, 3Analysis Group, Boston, MA, USA, 4Duke Cancer Institute, Durham, NC, USA
OBJECTIVES: Venetoclax, combined with azacitidine or decitabine, received FDA approval for treating newly diagnosed (ND) acute myeloid leukemia (AML) patients who are aged 75 years or older or have comorbidities precluding use of intensive chemotherapy. This study evaluated the budget impact of adopting venetoclax combinations for this population from a US third-party payer perspective.
METHODS: A model was developed to estimate the 3-year budget impact of adopting venetoclax combinations in a hypothetical US health plan with 1 million members (60% Commercial, 40% Medicare). Eligible patients were estimated using public epidemiological data. The most up-to-date market share, reflecting the current treatment landscape projected venetoclax + azacitidine or decitabine to capture 53% and 15% market share, respectively, from existing treatments (azacitidine, low-dose cytarabine [LDAC], decitabine, ivosidenib, gemtuzumab ozogamicin, glasdegib + LDAC, and ivosidenib + azacitidine). The model considered costs of drug and administration, adverse events, hospitalization, disease monitoring, blood transfusions, and subsequent AML management. All costs were adjusted to 2024 USD. Clinical inputs for venetoclax + azacitidine or decitabine were informed by the final VIALE-A and M14-358 data, respectively. Incremental budget impact was calculated on a per-member-per-month (PMPM) basis. One-way sensitivity analyses were performed.
RESULTS: In a 1-million-member health plan, 48 patients were eligible for venetoclax combinations. Annual cost of venetoclax + azacitidine ($258,498) or decitabine ($259,921) were lower than the highest-cost comparator treatments, ivosidenib + azacitidine ($477,520) and ivosidenib ($404,869). While adoption of venetoclax combinations led to an increase in drug costs, these were offset by their lower subsequent AML management costs, resulting in a PMPM cost saving of $0.0476 for Years 1-3. The model results remained robust in sensitivity analyses.
CONCLUSIONS: Use of venetoclax combinations for the treatment of FDA-approved indication of ND AML reduced the budget impact and provides potential financial benefit for US payers.
METHODS: A model was developed to estimate the 3-year budget impact of adopting venetoclax combinations in a hypothetical US health plan with 1 million members (60% Commercial, 40% Medicare). Eligible patients were estimated using public epidemiological data. The most up-to-date market share, reflecting the current treatment landscape projected venetoclax + azacitidine or decitabine to capture 53% and 15% market share, respectively, from existing treatments (azacitidine, low-dose cytarabine [LDAC], decitabine, ivosidenib, gemtuzumab ozogamicin, glasdegib + LDAC, and ivosidenib + azacitidine). The model considered costs of drug and administration, adverse events, hospitalization, disease monitoring, blood transfusions, and subsequent AML management. All costs were adjusted to 2024 USD. Clinical inputs for venetoclax + azacitidine or decitabine were informed by the final VIALE-A and M14-358 data, respectively. Incremental budget impact was calculated on a per-member-per-month (PMPM) basis. One-way sensitivity analyses were performed.
RESULTS: In a 1-million-member health plan, 48 patients were eligible for venetoclax combinations. Annual cost of venetoclax + azacitidine ($258,498) or decitabine ($259,921) were lower than the highest-cost comparator treatments, ivosidenib + azacitidine ($477,520) and ivosidenib ($404,869). While adoption of venetoclax combinations led to an increase in drug costs, these were offset by their lower subsequent AML management costs, resulting in a PMPM cost saving of $0.0476 for Years 1-3. The model results remained robust in sensitivity analyses.
CONCLUSIONS: Use of venetoclax combinations for the treatment of FDA-approved indication of ND AML reduced the budget impact and provides potential financial benefit for US payers.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE417
Topic
Economic Evaluation
Topic Subcategory
Budget Impact Analysis
Disease
SDC: Oncology